Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, School of Medicine, Daejeon, Korea.
Ann Surg Oncol. 2011 May;18(5):1306-11. doi: 10.1245/s10434-010-1469-2. Epub 2010 Dec 8.
We often observe that uptake of tracer is not detected in the primary cancer focus in patients with histologically proven papillary thyroid carcinoma (PTC) on preoperative (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT). Therefore, we analyzed the clinical and pathologic variables affecting false-negative findings in primary tumors on preoperative (18)F-FDG PET/CT.
We retrospectively reviewed the medical records of 115 consecutive patients who underwent (18)F-FDG PET/CT for initial evaluation and were diagnosed with PTC by postoperative permanent biopsy. The clinical and pathologic characteristics that influence the (18)F-FDG PET/CT findings in these patients were analyzed with respect to the following variables: age, gender, tumor size, multifocality of the primary tumor, perithyroidal invasion, lymphovascular or capsular invasion, and central lymph node metastasis-based final pathology.
Twenty-six (22.6%) patients had false-negative (18)F-FDG PET/CT findings. In patients with negative (18)F-FDG PET/CT findings, tumor size, and perithyroidal and lymphovascular invasion were significantly less than in patients with positive (18)F-FDG PET/CT findings. Tumors >1 cm in size were correlated with (18)F-FDG PET/CT positivity. On multivariate analysis, perithyroidal invasion (P = 0.026, odds ratio = 7.714) and lymphovascular invasion (P = 0.036, odds ratio = 3.500) were independent factors for (18)F-FDG PET/CT positivity. However, there were no significant differences between (18)F-FDG PET/CT positivity and age, gender, capsular invasion, and central lymph node metastasis based on final pathology.
Tumor size and perithyroidal and lymphovascular invasion of papillary carcinoma can influence (18)F-FDG PET/CT findings. Absence of perithyroidal and lymphovascular invasion were independent variables for false-negative findings on initial (18)F-FDG PET/CT in patients with PTC.
我们经常观察到，在术前（18）F-氟代脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（（18）F-FDG PET/CT）中，经组织学证实的甲状腺乳头状癌（PTC）患者的原发癌灶中未检测到示踪剂摄取。因此，我们分析了影响术前（18）F-FDG PET/CT 中原发肿瘤假阴性结果的临床和病理变量。
我们回顾性分析了 115 例连续患者的病历，这些患者因初始评估而行（18）F-FDG PET/CT 检查，并通过术后永久性活检诊断为 PTC。分析了这些患者的以下变量对（18）F-FDG PET/CT 结果的影响：年龄、性别、肿瘤大小、原发肿瘤的多灶性、甲状腺周围侵犯、血管淋巴管侵犯和中央淋巴结转移的最终病理学。
26 例（22.6%）患者的（18）F-FDG PET/CT 结果为假阴性。在（18）F-FDG PET/CT 结果阴性的患者中，肿瘤大小、甲状腺周围侵犯和血管淋巴管侵犯明显小于（18）F-FDG PET/CT 结果阳性的患者。肿瘤>1cm 与（18）F-FDG PET/CT 阳性相关。多变量分析显示，甲状腺周围侵犯（P=0.026，优势比=7.714）和血管淋巴管侵犯（P=0.036，优势比=3.500）是（18）F-FDG PET/CT 阳性的独立因素。然而，根据最终病理学，（18）F-FDG PET/CT 阳性与年龄、性别、包膜侵犯和中央淋巴结转移之间无显著差异。
肿瘤大小和甲状腺周围及血管淋巴管侵犯可影响（18）F-FDG PET/CT 结果。在 PTC 患者中，甲状腺周围和血管淋巴管侵犯的缺失是（18）F-FDG PET/CT 初诊假阴性结果的独立变量。
